title: Mindfulness-based stress reduction versus pharmacotherapy for chronic primary insomnia: a randomized controlled clinical trial.
abstract: OBJECTIVE
  The aim of this study was to investigate the potential of mindfulness-based stress reduction (MBSR) as a treatment for chronic primary insomnia.
  
  
  METHODS
  A randomized controlled trial was conducted.
  
  
  METHODS
  The study was conducted at a university health center.
  
  
  METHODS
  Thirty adults with primary chronic insomnia based on criteria of the Diagnostic and Statistical Manual of Mental Disorders, Text Revision, 4th Edition were randomized 2:1 to MBSR or pharmacotherapy (PCT).
  
  
  METHODS
  Mindfulness-based stress reduction, a program of mindfulness meditation training consisting of eight weekly 2.5 hour classes and a daylong retreat, was provided, with ongoing home meditation practice expectations during three-month follow-up; PCT, consisting of three milligrams of eszopiclone (LUNESTA) nightly for eight weeks, followed by three months of use as needed. A 10-minute sleep hygiene presentation was included in both interventions.
  
  
  RESULTS
  The Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), sleep diaries, and wrist actigraphy were collected pretreatment, posttreatment (eight weeks), and at five months (self-reports only).
  
  
  RESULTS
  Between baseline and eight weeks, sleep onset latency (SOL) measured by actigraphy decreased 8.9 minutes in the MBSR arm (P < .05). Large, significant improvements were found on the ISI, PSQI, and diary-measured total sleep time, SOL, and sleep efficiency (P < .01, all) from baseline to five-month follow-up in the MBSR arm. Changes of comparable magnitude were found in the PCT arm. Twenty-seven of 30 patients completed their assigned treatment. This study provides initial evidence for the efficacy of MBSR as a viable treatment for chronic insomnia as measured by sleep diary, actigraphy, well-validated sleep scales, and measures of remission and clinical recovery.
authors.affiliation: College of Pharmacy, University of Minnesota, Minneapolis, MN, USA. gross002@umn.edu
authors.forename: Cynthia R
authors.initials: CR
authors.lastname: Gross
authors.forename: Mary Jo
authors.initials: MJ
authors.lastname: Kreitzer
authors.forename: Maryanne
authors.initials: M
authors.lastname: Reilly-Spong
authors.forename: Melanie
authors.initials: M
authors.lastname: Wall
authors.forename: Nicole Y
authors.initials: NY
authors.lastname: Winbush
authors.forename: Robert
authors.initials: R
authors.lastname: Patterson
authors.forename: Mark
authors.initials: M
authors.lastname: Mahowald
authors.forename: Michel
authors.initials: M
authors.lastname: Cramer-Bornemann
mesh_terms: D056044:Actigraphy / Q000379:methods; D000328:Adult; D000368:Aged; D053961:Azabicyclo Compounds / Q000627:therapeutic use*; D000069582:Eszopiclone; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008297:Male; D019122:Meditation; D008875:Middle Aged; D010349:Patient Compliance; D010879:Piperazines / Q000627:therapeutic use*; D012890:Sleep / Q000187:drug effects; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy / Q000628:therapy*; D013315:Stress, Psychological / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D053961:Azabicyclo Compounds; D006993:Hypnotics and Sedatives; D010879:Piperazines; D000069582:Eszopiclone